Analysis of the bypass angioplasty revascularization investigation trial using a multistate model of clinical outcomes

The American Journal of Cardiology
Xiao ZhangC Noel Bairey Merz

Abstract

Current cardiovascular randomized trials typically use composite outcomes. We hypothesized that the Bypass Angioplasty Revascularization Investigation (BARI) outcomes and conclusions would differ using a multistate model relative to the intervention for the composite outcome of death (D) and nonfatal Q-wave myocardial infarction (MI). We used a multistate model which uses transition paths to simultaneously assess multiple end points. Using the 10-year follow-up BARI data, we post hoc analyzed outcomes according to 3 transition paths: (1) from intervention to MI; (2) from intervention to death; and (3) from MI to death. Of 1,829 patients randomized to the intervention of percutaneous transluminal coronary angioplasty or coronary artery bypass grafting (CABG), 700 (38%) experienced the composite event D/MI which included 230 (13%) nonfatal MI and 470 (26%) death without antecedent nonfatal MI, whereas 79 of 230 (34%) experienced death after nonfatal MI. Outcomes of the 3 individual transition paths were analyzed by a multistate model. In contrast to standard survival analyses, after adjustment for baseline clinical covariates, outcomes after percutaneous transluminal coronary angioplasty or CABG were not significantly different f...Continue Reading

References

Jul 25, 1996·The New England Journal of Medicine·UNKNOWN Bypass Angioplasty Revascularization Investigation (BARI) Investigators
Mar 1, 2000·Statistics in Medicine·P K AndersenT I Sorensen
Jun 15, 2001·Statistics in Medicine·N KeidingM M Horowitz
Jul 19, 2006·Biometrical Journal. Biometrische Zeitschrift·Hein PutterCornelis J H van de Velde
Oct 13, 2006·Statistics in Medicine·H PutterR B Geskus
Apr 22, 2008·Statistics in Medicine·Marta FioccoHans C van Houwelingen
Mar 29, 2012·The New England Journal of Medicine·William S WeintraubFred H Edwards
Nov 6, 2012·The New England Journal of Medicine·Michael E FarkouhUNKNOWN FREEDOM Trial Investigators
Dec 7, 2013·Statistics in Medicine·A S C ConlonD J Sargent

❮ Previous
Next ❯

Citations

May 30, 2016·Revista Española De Cardiología·Morteza HajihosseiniJavad Faradmal
Nov 10, 2017·Statistical Methods in Medical Research·Hilary Aralis, Ron Brookmeyer
Apr 11, 2020·Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research·S Scott SuttonJames W Hardin
Apr 19, 2018·Inflammatory Bowel Diseases·Parakkal DeepakDavid H Bruining
Jul 31, 2021·Revista Española De Cardiología·Xavier Rossello, Maribel González-Del-Hoyo

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Cardiovascular Diseases: Risk Factors

Cardiovascular disease is a significant health concern. Risk factors include hypertension, obesity, dyslipidemia and smoking. Women who are postmenopausal are at an increased risk of heart disease. Here is the latest research for risk factors of cardiovascular disease.